宫腔镜联合左炔诺孕酮宫内节育系统治疗异常子宫出血的临床效果

Clinical Effect of Hysteroscopy Combined with Levonorgestrel Intrauterine System in the Treatment of Abnormal Uterine Bleeding

目的:研究宫腔镜+左炔诺孕酮宫内节育系统运用于异常子宫出血中的价值。方法:选择罗定市中医院2020年1月-2021年2月收治的异常子宫出血患者70例,按随机数字表法分为两组,各35例,研究组接受宫腔镜+左炔诺孕酮宫内节育系统,对照组接受宫腔镜,对比两组总有效率、治疗前后测定两组的孕酮、促卵泡生成激素、雌二醇、促黄体生成激素、月经时间、月经量、子宫内膜厚度、孕激素受体(PR)、雌激素受体(ER)、血管内皮生长因子(VEGF)指标,并统计两组不良反应发生率。结果:治疗后3个月,研究组总有效率为91.43%,高于对照组的71.43%(P<0.05)。治疗前两组性激素指标比较,差异均无统计学意义(P>0.05),治疗后3个月,研究组孕酮、促卵泡生成激素、雌二醇、促黄体生成激素均低于对照组(P<0.05)。治疗前两组月经时间、月经量、子宫内膜厚度相比,差异均无统计学意义(P>0.05),治疗后3个月,研究组月经时间短于对照组,月经量少于对照组,子宫内膜厚度薄于对照组(P<0.05)。治疗后3个月,研究组不良反应发生率为8.57%,与对照组的17.14%相比,差异无统计学意义(P>0.05)。治疗前两组PR、ER、VEGF相比,差异均无统计学意义(P>0.05),治疗后3个月,研究组PR、ER均低于对照组,但VEGF高于对照组(P<0.05)。结论:宫腔镜+左炔诺孕酮宫内节育系统运用于异常子宫出血中疗效显著,促进性激素水平恢复,改善子宫内膜厚度及月经状况,调节PR、ER,防止严重不良反应出现。

Objective:To study the value of hysteroscopy+Levonorgestrel Intrauterine System in the treatment of abnormal uterine bleeding.Method:A total of 70 patients with abnormal uterine bleeding in Luoding Hospital of Traditional Chinese Medicine from January 2020 to February 2021 were randomly divided into two groups with 35 cases in each group.The study group received hysteroscopy+Levonorgestrel Intrauterine System and the control group received hysteroscopy.The total effective rates of the two groups were evaluated.The progesterone,follicle stimulating hormone,estradiol,luteinizing hormone,menstrual time,menstrual volume,endometrial thickness,progesterone receptor(PR),estrogen receptor(ER),vascular endothelial growth factor(VEGF)of the two groups were measured before and after treatment,the incidence of adverse reactions in the two groups were counted.Result:Three months after treatment,the total effective rate in the study group was 91.43%,which was higher than 71.43%in the control group(P<0.05).There were no differences in sex hormone indexes between the two groups before treatment(P>0.05).Three months after treatment,progesterone,follicle stimulating hormone,estradiol and luteinizing hormone in the study group were lower than those in the control group(P<0.05).There were no differences in the menstrual time,menstrual volume and endometrial thickness between the two groups before treatment(P>0.05).Three months after treatment,the menstrual time of the study group was shorter than that of the control group,menstrual volume was less than that of the control group,and endometrial thickness of the study group was thinner than that of the control group(P<0.05).Three months after treatment,the adverse reactions in the study group were 8.57%and 17.14%in the control group,there was no significant difference(P>0.05).There was no difference in PR,ER,and VEGF between the two groups before treatment(P>0.05).Three months after treatment,PR and ER in the study group were lower than those in the control group,but VEGF was higher than that in the control group(P<0.05).Conclusion:Hysteroscopy+Levonorgestrel Intrauterine System is effective in abnormal uterine bleeding,promote the recovery of sex hormone level,improve endometrial thickness and menstrual status,regulate PR and ER,and prevent serious adverse reactions.